Coronavirus Diary (13): Four Suggestions

I’m generally in favor of the so-called “lockdown” policies that have been adopted in New York and New Jersey, but I also think that the policies have been slightly misconceptualized in the abstract, and are now starting to go somewhat off the rails in practice. Here are a couple of simple suggestions.

(1) Playgrounds. Close all playgrounds now–taking “playground” to be the part of a park that has jungle gyms and the like. COVID-19 can survive for long periods of time on surfaces of the sort found in playgrounds. If kids are allowed to play in playgrounds, the virus will very likely find its way onto their hands, into their mouths, noses, eyes, and butts, and very likely infect them. They will in turn very likely infect others, who may, somewhere downstream, sicken or kill someone. DiBlasio’s dithering on this issue has been dismaying to see (as dismaying as his stupid decision to keep going to public gyms long past when it was appropriate to do so). Stop dithering and do it now.

(2) Be judicious about enforcement. It’s worth remembering that the lockdown is a blunt instrument to promote/enforce social distancing. It should not become so blunt an instrument that otherwise safe human action becomes collateral damage as a result. It’s in danger of doing that. Actually, the danger was there from the outset.

Take, for instance, the curfew. I understand its rationale; in a very broad, probabilistic way, it stops underground parties, and promotes/enforces social distancing. So I can’t offer a wholehearted criticism of it. But the authorities should realize that it is also somewhat self-undermining: it vitiates the possibility of action as such. We do not, or should not, want people to become passive couch potatoes during this crisis. We need them to step up and take appropriate action–even if the action in question has to take place past curfew. It is not unsafe (at all) for an individual to be driving alone in her car past curfew, among other things that happen, technically, to be illegal right now.

And don’t forget that the courts are not operating, that cops are more likely to give people COVID-19 than most people are, and that (with all due respect to them) there are probably as many cops in this state willing to abuse their authority as there are non-cops willing to indulge in irresponsibility. God help me if I get stopped by a cop for breaking curfew as I’m driving supplies to a hospital, or driving somewhere to help a friend in need, or whatever. And God help the cop, too. I know there are cops out there who have good judgment. For God’s sake, use it.

(3) Repurpose vacated college dorms as quarantine facilities. I wrote this last proposal up in a previous post, but in what strikes me in retrospect as an excessively chatty form. Here it is again; we should re-purpose vacated college dorms to quarantine medical personnel, and patients as well–quarantining them, as per my brother’s suggestion, by category in different buildings. His argument to that end really can’t be improved on. Suppose doctors like him test positive for COVID-19, and can’t return home.

[A]s a potentially infected person I individually would be ill-advised to privately rent a hotel room for myself on a one-off basis as a means of self-quarantine.

A hotel might serve as an adequate location for institutional quarantine if health authorities took control of the entire building, evicted the current residents, ensured that it adhered to infection control standards, and altered the environmental services and systems accordingly (HVAC, etc.). Hotels have forced air heating and ventilation systems that may promote the spread of infection. Hotel conditions may also promote spread to housekeeping staff.

Granted, dorms face some of the same problems but have the advantages of having fewer problematic surfaces (e.g., wall-to-wall carpet, fabric drapes and wallpaper) and of already being empty as of this time.

Also because colleges have several separate dormitory buildings, you could safely house (a) international students [or any others still there], (b) low-risk patients who are pending rest results (i.e., lower likelihood of having disease), (c) higher-risk patients who are pending results (i.e., higher likelihood of having disease), and (d) confirmed test-positive cases. Unlike a single hotel building, you could put each category of patient in a different building to avoid cross-contamination.

The CDC website does actually suggest as an infection control measure that communities develop non-hospital alternative dwellings for patients who need them to quarantine. I don’t have the link to the exact page right now, but it’s there.

(4) Focus. One last suggestion. We need to move fast. Forget conspiracy theories, political recriminations, blame games, or the temptation to enact the 21st-century American version of the Night of the Long Knives. Forget what-aboutisms, pointless grandstanding, and grand postures. Forget hypothetical scenarios, and the fantasy of going back in time, and walking forward again. We do not fucking have time for that. Save it for later.

In some ways, our collective response to this crisis has been a shit-show, but in other ways, many people will someday deserve accolades for stepping up. Yes, we’ve fucked up, but we’ve also staged an amazing comeback. That comeback will gain force if it harnesses the power of people taking the initiative to solve whatever part of the problem they can solve–to make whatever marginal contribution they can manage or afford.* We can’t sit here and wait for someone to “take care” of us–at least not those of us fortunate enough to have the resources or capacity to act. We each have to figure out what we can do, or at least ought to avoid doing, and act appropriately. There isn’t going to be a happy ending here. But it doesn’t have to be an-all out catastrophe.

*Thanks to Eileen Condon for the Democracy Now link. Though I don’t necessarily agree with all of it, on the whole, Democracy Now has published some excellent stuff on this crisis. Well worth checking out.

Mutual Aid NYC is growing exponentially behind the scenes and launch of its full menu of broad-coalition-based services by groups large and small, old and new, is coming very soon. It’s huge. Be encouraged.

But the proposal seems to concern the quarantining of patients, not health care workers. Suleman tells me that some of the physicians on his hospital’s front-line team are already out of commission; it’s not clear how they’ve handled that.

One thing that worries me is the possibility that the choices might be made more on financial than on logistical or epidemiological grounds.

New York is working with the hospitality industry to possibly convert entire hotels into hospitals for patients without the coronavirus, the city’s emergency management commissioner, Deanne Criswell, told The Wall Street Journal last week.

The decision to use hotels figures to be a financial benefit for the hotel industry, the American Hotel and Lodging Association told NJ Advance Media on Tuesday.

All I can say is that I hope they’re made more on logistical-epidemiological than financial grounds. But as neither Suleman nor I have any expertise in this field, I’ll leave the matter there. I might have to babysit after all.

Right now, while Holy Name Hospital appears to be in a dire situation, Valley Hospital has space; they’ve expanded the hospital substantially, and (unfortunately) created space by canceling elective procedures (in a very broad sense of “elective,” I’m afraid–justified by the necessity of the moment, but painful nonetheless). So at the moment, there is no dire shortage of beds at Valley, at least. The question is whether that will hold as we climb the curve of exponential growth.

I asked him whether he thought that patients could be transferred from smaller hospitals like Valley to larger ones like St Barnabas, University Hospital Rutgers, or Robert Wood Johnson. He thought not. “It’s too risky for the people transporting the patients, and in any case, it just ends up undermining the response of those larger institutions.” Implication: they have to tough it out and hope for the best.

I asked whether he thought (as I do) that the pendulum is now swinging from incaution about social distancing to paranoia. He agreed, in a qualified way. Half the problem, he says, is that most people don’t understand how exponential growth works. They engage in social distancing, expect to see a reduction in case loads the next day, see the reverse, and become confused. In order to keep them on track, they’re then frightened into compliance. It may be the best we can do right now, but it’s problematic.

Note to self: once this nightmare is over, do a better job of integrating math into the philosophy curriculum, while teaching both applied ethics and critical thinking. Never again accept the lame excuses of math- or science-phobia.

This suggestion is generally on target. It’s compatible with my “dorm re-purposing” idea, and might be done simultaneously with it.

I’ve so far tried to bring my dorm re-purposing idea to the attention of New Jersey’s commissioner for health, Judith Persichilli, as well as my three state legislators (Christopher Bateman, Roy Freiman, and Andrew Zwicker, all in the 16th state legislative district for New Jersey). Hoping to hear back from them soon.

My impression is that Order is basically sound. It certainly raises questions, and it’s hard to know how it’s being enforced on the ground. I’ve heard a few (mild) stories of misenforcement. But on the whole, I don’t object to it. My students have raised some interesting questions, drawn from their experiences, about how it applies to this or that case. If they agree, I’ll post some of those on PoT.